{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:46:49Z","timestamp":1782409609649,"version":"3.54.5"},"reference-count":91,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reviews in Medical Virology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Hepatitis B virus (HBV) remains a significant occupational hazard for healthcare workers (HCWs), especially in low\u2010 and middle\u2010income countries (LMICs) where vaccination coverage is often suboptimal. This review examined the non\u2010vaccination rate against HBV among HCWs in LMICs. We conducted a systematic search across multiple databases, including PubMed\/MEDLINE, Embase, Web of Science, and Scopus, for studies published from the inception up to 04 Feb 2024. Non\u2010vaccination (NV) was defined as the absence of any hepatitis B vaccination dose as reported by individual studies. Pooled NV rates were calculated using a random\u2010effects model. This review was registered in PROSPERO (CRD42024510223). The search retrieved 2990 studies, of which 62 met the eligibility criteria for the final analysis, including data from over 23,000 HCWs. The pooled prevalence of unvaccinated (zero\u2010dose) HBV individuals was 36.2% (95% CI: 27.7%\u201345.5%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a098.9%). Subgroup analysis revealed marked disparities, with the highest prevalence in low\u2010income countries (61.4%; 95% CI: 30.6%\u201385.1%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a098.7%) compared to upper\u2010middle\u2010income countries (20.4%; 95% CI: 7.8%\u201343.9%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a098.8%). Regionally, the burden was greatest in Africa (45.3%; 95% CI: 32.7%\u201358.4%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a098.9%) and lowest in Latin America (8.8%; 95% CI: 0.0%\u201399.9%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a092.7). This review found that more than one\u2010third of healthcare workers remain unvaccinated against HBV, with marked disparities across income levels and geographic regions. The consistently high heterogeneity suggests these gaps are context\u2010specific, highlighting the need for targeted strategies to improve vaccine uptake and equity.\n                  <\/jats:p>","DOI":"10.1002\/rmv.70169","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T10:48:49Z","timestamp":1779446929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis B Non\u2010Vaccination Rate and Associated Factors Among Healthcare Workers in Low\u2010 and Middle\u2010Income Countries: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9864-5469","authenticated-orcid":false,"given":"Alphonce Ignace","family":"Marealle","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7224-2251","authenticated-orcid":false,"given":"Goodluck G.","family":"Nyondo","sequence":"additional","affiliation":[{"name":"Department of Medicinal Chemistry Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine Aron","family":"Manguzu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Castory G.","family":"Munishi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutics and Pharmacy Practice Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4867-7200","authenticated-orcid":false,"given":"George Msema","family":"Bwire","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Microbiology Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.35"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)60220\u20108"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)31865\u20108"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.livres.2024.05.004"},{"key":"e_1_2_11_6_1","unstructured":"World Health Organization \u201cHepatitis B \u201d (2025) Retrieved October 23 2024 from https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hepatitis\u2010b."},{"key":"e_1_2_11_7_1","unstructured":"World Health Organization \u201cHepatitis B Is Preventable With Safe and Effective Vaccines \u201d (n.d.) 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